Thousands of lives could be saved thanks to a new heart drug hailed as the biggest breakthrough since statins.
In a landmark four-year trial, scientists found that the drug – given by injection every three months – cut the risk of heart attacks by a quarter.
The 10,000-patient study, involving 1,000 doctors in 39 countries, also suggested it could halve the risk of dying from lung cancer and prevent arthritis and gout.
Scientists last night said the treatment marked ‘a new era of therapeutics’ that could save thousands of lives.
The drug, Canakinumab, works by reducing inflammation – a major new approach in heart medicine.
For the past 30 years cholesterol-busting statins have been given to nearly all people deemed to be at risk of cardiovascular disease in a bid to save them from heart attacks and strokes. Yet half of the 200,000 people who have a heart attack in Britain each year do not have high cholesterol, meaning there is a desperate need for a different approach to treatment.
Experts have long thought that inflammation – the body’s natural responses to infection or injury – might also play a major role in causing heart attacks and strokes, possibly because it causes the condition to flare in the arteries, increasing the risk of a blockage.
The new trial, however, is the first definitive proof that cutting inflammation slashes heart risk.
Study leader Professor Paul Ridker of Harvard Medical School said the new drug opened up a ‘third front’ in the war on heart disease, following the previous focus on cholesterol and lifestyle.
Presenting his findings at the European Society of Cardiology congress in Barcelona yesterday, Prof Ridker said: ‘These findings represent the end game of more than two decades of research, stemming from a critical observation – half of heart attacks occur in people who do not have high cholesterol.
‘For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk.’
Prof Ridker, whose results are published in the New England Journal of Medicine, added: ‘This has far-reaching implications.
‘It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high-risk populations.’
Canakinumab is an antibody that attacks an immune-system protein called interleukin-1, which in high levels results in increased inflammation throughout the body.
The trial involved high-risk patients who had already suffered a heart attack – a group in desperate need of help because a quarter of patients suffer a second attack within five years, even with statins.
All patients in the trial took statins as well, but the research team found the addition of Canakinumab cut the risk of repeat heart attacks by 24 per cent, over and above the impact of the cholesterol drug.
People who took the drug were also 36 per cent less likely to be hospitalised with unstable angina, and 32 per cent less likely to require expensive interventional procedures such as bypass surgery.
Researchers reported a sharp rise in infections – a side effect linked to the fact inflammation protects against infection – which killed one in every 1,000 patients.
But they also found patients had a 51 per cent reduced risk of lung cancer deaths – a finding they said was ‘very exciting’ and needed further trials. Gout and arthritis, which are linked to inflammation, also fell.
Drugs giant Novartis, which makes Canakinumab, said it would immediately apply for a medical licence to use the drug for heart disease.
Canakinumab is used for inflammatory problems, including rare forms of arthritis, at the cost of £9,928 per jab. It is expensive because the conditions are rare, so sales are low. Experts said the price – £40,000 a year for heart patients – would have to come down if it were to be made available on the NHS.
Professor Jeremy Pearson, of the British Heart Foundation, said: ‘These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and could help save lives.’
American cardiologist Steven Nissen said: ‘This is as big as anything we’ve seen in a while. It’s a gateway to a very wide variety of therapies that are going to be developed.’